Chronic opioid therapy issues associated with opioid abuse potential

Authors

  • Howard S. Smith, MD
  • Kenneth L. Kirsh, PhD
  • Steven D. Passik, PhD

DOI:

https://doi.org/10.5055/jom.2009.0029

Keywords:

opioids, drug abuse, prescribing, risk, screening

Abstract

Chronic opioid therapy continues to be an important “mainstream” option for the relief of pain, despite continued debate over the efficacy and safety of utilizing opioids with chronic noncancer populations. With this increase in utilization for medical purposes, the authors have also experienced a troubling rise in the abuse and diversion of prescription opioids. Providers should note this relationship and always perform due diligence when assessing whether a patient with chronic noncancer pain is an appropriate candidate for opioid therapy based on potential risk factors. Because of the relative shortage of board-certified pain practitioners in the United States, much of the practice of pain management falls on primary care providers, who might feel uncomfortable or overwhelmed when facing these issues. To this end, a set of guidelines are discussed to promote an approach to chronic noncancer pain utilizing “universal precautions” principles. In addition, several risk tools are evaluated, including the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R), the Opioid Risk Tool (ORT), and the Pain Assessment and Documentation Tool (PADT). Finally, discussion is presented regarding what practices seen in opioid prescribing can be considered “in-or-out” of the mainstream box.

Author Biographies

Howard S. Smith, MD

Associate Professor and Director of Pain Management, Albany Medical College, Department of Anesthesiology, Albany, New York.

Kenneth L. Kirsh, PhD

Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky.

Steven D. Passik, PhD

Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, New York.

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Published

01/29/2018

How to Cite

Smith, MD, H. S., K. L. Kirsh, PhD, and S. D. Passik, PhD. “Chronic Opioid Therapy Issues Associated With Opioid Abuse Potential”. Journal of Opioid Management, vol. 5, no. 5, Jan. 2018, pp. 287-00, doi:10.5055/jom.2009.0029.